摘要:

Purpose.Researchers have recommended use of the Stages of Change in Exercise Adherence (STAGES), a process-oriented model, to better understand exercise adherence behavior. This study aimed to further understand the process by evaluating the predictors of exercise adherence and the validity of the STAGES model among older adults (N = 349) with a cardiac diagnosis after discharge from a cardiac rehabilitation inpatient program.Methods.Recently discharged inpatient participants, aged 65 years or older and ambulatory, responded to a computer-as-sisted telephone interview regarding their exercise behaviors and attitudes toward exercise (mean response time = 32.3 minutes). Between 55 and 80 participants in each of five stages of exercise adherence were interviewed. Demographic profiles and other information were obtained from a chart review of cardiac rehabilitation inpatient records.Results.Perceived self-efficacy, perceived benefits of exercise, interpersonal support for exercise, and perceived barriers to exercise were significant predictors of exercise adherence using direct entry discriminant analysis. These predictors accounted for 50% of the variance in stage of exercise adherence. The theoretical ordering of the STAGES model was supported (P <.0001). Exercise time significantly increased with each subsequent stage of exercise adherence from the precontemplation stage to the maintenance stage.Conclusions.This study evaluated the validity of the STAGES model in a sample of older cardiac rehabilitation participants. The STAGES model can be applied to the study of exercise behavior among this group of older adults.

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background.This study examined the effects of a nurse-case-managed, multifactorial, risk-reduction program on psychological distress among patients after myocardial infarction (MI).Methods.Five hundred eighty-five men and women aged 70 years or younger, who were hospitalized for acute MI in one of five San Francisco Bay Area hospitals, were randomized to receive a nurse-managed, home-based, multifactorial risk-reduction program (n = 293) or usual care (n = 292). The program, which began in the hospital, included a brief screen for five areas of psychological distress with further evaluation if indicated, monitoring during the follow-up phone calls, and referral for mental health treatment if needed. Patients were assessed with singleitem scales at baseline, and at 6 and 12 months. Separate analyses were performed for patients with moderate-to-severe levels on the psychological distress domains and for those with low levels.Results.There was a significant reduction in the psychological distress variables for all patient groups between baseline and 12 months. The program had a significant effect on reducing anxiety in the patient group with low levels of anxiety and reducing anger in the patient group with frequent episodes of anger but, overall, the treatment and control groups showed equal levels of improvement.Conclusion.Among patients post-MI without complications, psychological distress decreases significantly during the 12 months after MI.

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background.Assessing depression in cardiac patients is challenging because somatic symptoms of depression may be the result of physical illness. This study examined self-reported symptoms of depression in patients with cardiovascular disease.Method.Three hundred six patients with cardiovascular disease completed the Inventory to Diagnose Depression (IDD), which is a self-report depression scale.Results.Practically all patients reported some symptoms on the IDD, but only a small number had scores in the range suggestive of depression. Somatic symptoms did not contribute disproportionately to depression scores but affective and cognitive symptoms were stronger indicators of depression in these patients. Factor analysis identified one factor that represented a general syndrome of depression.Conclusions.The results suggest that the IDD has promise as a measure to screen for depression in cardiac patients.

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background.Patients with severe chronic obstructive pulmonary disease (COPD) may develop dyspnea with minimal arm activity, thoracoabdominal dyssynchrony with unsupported arm exercise (UAEX) and increased oxygen uptake (V˙O2), and minute ventilation (V˙E) with simple unsupported arm elevation (UAE) and UAEX. We investigated whether unsupported arm training, as the only form of exercise, could decrease the V˙O2and V˙E cost (percentage increase from resting baseline) associated with unsupported arm elevation and exercise, respectively.Methods.Twenty-six patients with severe COPD were randomized to 21-24 sessions of unsupported arm (ARMT) or low-intensity resistive breathing (RBT) training as the only form of exercise. Patients were studied before and after training using a metabolic cart and esophageal and gastric pressures to evaluate metabolic and respiratory muscle function.Results.After ARMT, the V˙O2(58% vs 38% increase, P < 0.05) and V˙E (41% v. 21% increase, P < 0.05) cost for UAEX at exercise isotime decreased and endurance time increased. Similarly the V˙O2(25% vs 18% increase, P < 0.05) cost decreased and V˙E no longer increased in response to 2 minutes of UAE after ARMT. The RBT group showed no such change. No improvement in ventilatory load or respiratory muscle function could be identified to explain the physiologic changes observed. After ARMT, mean inspiratory flow (VT/TI), a measure of central respiratory drive, was reduced during UAEX and the expected increase during UAE did not occur.Conclusion.We conclude that arm training reduces the V˙O2and V˙E cost of UAE and UAEX, possibly through improved synchronization and coordination of accessory muscle action during unsupported arm activity.

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1997

数据来源: OVID